Loop Excision of the Transformation Zone

Treatment protocol for CIN/SIL abnormalities has been refined to provide for the most effective disease management. For example, non-surgical management – e.g., observation – of lower grade lesions is considered essential to minimizing obstetric risks such as pre-term delivery and cervical incompetence. However, complication-free treatment of high grade disease is essential for minimizing the risk of disease progression to cervical cancer.

When indicated, excision of the lesion must be accomplished with precision. Complete removal of the lesion (e.g., clear specimen excision margins) is essential for effective CIN management, yet excessive removal of non-involved cervical stroma can increase the risk of preterm labor and complications in future pregnancies. UtahLoop electrodes provide a rigid tungsten wire with adjustable support. Loop flex is minimized to provide highly controllable excision depth, and specimen count is minimized to contribute to effective histopathology.

Specific to UtahLoop® electrodes, the adjustable Safe-T-Gauge® is set to the desired maximum excision depth, often near 8mm. This provides an excellent reference for depth control, and prevents over-excision of healthy cervical tissue should the patient move during the procedure.

In some patients, endocervical involvement is present, and traditional double-loop excision or “top-hat” procedures are performed. With endocervical involvement, and when exocervical component is roughly symmetrical, and the cervix is fairly round, the C-LETZ Conization Electrode is an excellent means to achieve complete removal of the lesion with a single specimen. A rotational technique is used, meaning that the excised specimen is round rather than square. Also, the special contoured shape of the electrode body helps ensure consistency in excision depth, and the wire configuration minimizes excision margin involvement, yet preserves healthy tissue. Reference:
Miniconization procedure with C-LETZ conization electrode for treatment of cervical intraepithelial neoplasia: a Swedish study.

PRODUCT DESCRIPTION

UtahLoop® and UtahBall® gynecology electrodes are sterile, single use disposable electrodes for use with most electrosurgical units during loop excision of the transformation zone. C-LETZ® electrodes use a contoured wire element that, when rotated through 360 degrees in the cervical canal, excises a "cone" specimen that more closely conforms to the predicted infection pattern of CIN lesions.

FEATURES

• Loop electrodes have the Safe-T-Gauge® which allows the clinician to set the maximum depth of excision.
• All loop and needle electrodes utilize high grade tungsten wire.
• Color coded for ease in identification.
• Single-use and disposable, preventing cross-contamination and ensuring consistent performance on every procedure.
• Electrodes have an industry-standard 3/32" shaft diameter, and are compatible with all electrosurgical systems.
• Provide simultaneous hemostasis compared to cold knife conization.

CLINICAL REFERENCE

— Mints M, Gaberi V, Andersson S., Miniconization procedure with C-LETZ conization electrode for treatment of cervical intraepithelial neoplasia: a Swedish study. Acta Obstet Gynecol Scand. 2006;85(2):218-23.
— Janthanaphan M, Wootipoom V, Tangsinmunkong K, Liabsuetrakul T., Comparison of success rate and complications of contour-loop excision of the transformation zone (C-LETZ) with cold knife conization (CKC) in high grade lesion (HGL) from colposcopic impression. J Med Assoc Thai. 2009 Dec;92(12):1573-9.